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INDONESIA
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Published by Perhimpunan Dokter Spesialis Patologi Klinik Indonesia
ISSN : 08544263     EISSN : 24774685     DOI : https://dx.doi.org/10.24293
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) is a journal published by “Association of Clinical Pathologist” professional association. This journal displays articles in the Clinical Pathology and Medical Laboratory scope. Clinical Pathology has a couple of subdivisions, namely: Clinical Chemistry, Hematology, Immunology and Serology, Microbiology and Infectious Disease, Hepatology, Cardiovascular, Endocrinology, Blood Transfusion, Nephrology, and Molecular Biology. Scientific articles of these topics, mainly emphasize on the laboratory examinations, pathophysiology, and pathogenesis in a disease.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 1,328 Documents
 102   103   104   105   106 
Hematology Profile of Tuberculosis Lymphadenitis Patients at Siti Rahmah Hospital, Padang, Indonesia Debie Anggraini; Meta Zulyati Oktora
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1719

Abstract

Tuberculosis (TB) is a progressive granulomatous infectious disease caused by Gram-positive acid-resistant bacilli classified in the genus Mycobacterium. Tuberculosis in humans is caused by Mycobacterium tuberculosis (MTB) and it mainly infects the lungs, although it can also infect intestines, meninges, bones, lymph nodes, skin that cause extra-pulmonary TB. Tuberculous lymphadenitis is an inflammatory process in lymph nodes as a result of MTB activity. The inflammatory process caused by MTB activity is often associated with anemia as the most common complication. Anemia in TB is caused by an inflammatory process associated with bone marrow suppression due to pro-inflammatory cytokines, thus inhibiting the proliferation and differentiation of erythroid progenitor cells. This chronic TB infection also affects iron hemostasis, thus further affecting the hematological profile of TB patients. This study aimed to determine the hematology profile of TB lymphadenitis patients in the Siti Rahmah Hospital, Padang, Indonesia. This was a descriptive study, with a population of patients diagnosed with TB lymphadenitis based on the results of a fine needle biopsy in the Colli region. The samples of this study consisted of 24 patients who have tested the hematology profile. Tuberculosis lymphadenitis patients in females were higher than males, the mean age was 26.75±19.53 years old dominated by an adult (54%). The mean of 3 hemoglobin levels was 11.8±1.522 g/dL, with 62.5% anemia patients. The mean leukocyte count was 10400±3018.926/mm , 3 with 54.2% of patients had normal levels of leukocyte. The mean of thrombocyte count was 334750±74440.668/mm , with 83.3% in normal levels and the mean of Erythrocyte Sedimentation Rate (ESR) was 35.25±31.489 mm/h, with 54.2% patients in high ESR. Hematology profile in TB lymphadenitis patient was anemia, normal levels of leukocytes, thrombocyte, and increased levels of ESR.
Analysis of MTb Rapid Molecular Test Performance Towards Microscopical Acid Fast Bacilli Examination at Labuang Baji General Hospital Ummul Khair; Nursin Abd Kadir; Benny Rusli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1722

Abstract

Tuberculosis (Tb) is a global health problem, which is the third leading cause of death of all infectious diseases around the world, included Indonesia. Acid Fast Bacilli (AFB) smear and rapid molecular assay for Mycobacterium tuberculosis (MTb) are the old and new examinations required for MTb laboratory diagnosis. This study aimed to compare the performance of MTb rapid molecular assay and AFB smear in diagnosis and screening for Tb patients. This observational retrospective study used a cross-sectional approach, with a purposive sampling technique of 559 patients with suspected Tb in Labuang Baji Hospital, Makassar. This study was conducted from March 2019 to June 2019 by taking data from medical records from January 2018 to December 2018 at Labuang Baji Hospital, Makassar. Three hundred and forty-nine subjects were males (62.4%), and 210 subjects were females (37.6%). This study revealed sensitivity and specificity of 98.57% and 84.96%, respectively for MTb rapid molecular assay, and 68.65% and 99.44%, respectively for AFB smear, this shows that MTb rapid molecular assay was superior to AFB smear in diagnosing TB patients.
Diagnostic Value of Urinary Dysmorphic Erythrocytes in SLE Patients with Three Different Methods Ersa Bayung Maulidan; Ferdy Royland Marpaung
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1724

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with various clinical manifestations. Lupus nephritis is the most common severe manifestation with a poor prognosis. Hematuria is included in the Lupus Activity Criteria Count (LACC) and SLE Disease Activity Index (SLEDAI). Phase Contrast Microscope (PCM) availability as a recommended instrument for dysmorphic erythrocytes evaluation is exclusive, thus causing this examination to be performed rarely. This study aimed to investigate the diagnostic value of dysmorphic erythrocytes in SLE patients with hematuria using Low Condenser Light Microscope (LCLM), PCM, and UF-500i. This research was a cross-sectional study with consecutive sampling; 58 fresh urine samples were examined with UF-500i during May-July 2019. Percentage of dysmorphic erythrocytes were evaluated using LCLM and PCM. Difference percentages of dysmorphic erythrocytes were analyzed using the Wilcoxon Signed Ranks test, degree of agreement by Kappa coefficient, cut-off, sensitivity, and specificity by ROC curve. Dysmorphic erythrocyte percentage in LCLM and PCM showed a significant difference (p < 0.001) and a low degree of agreement (Kappa=0.373). Dysmorphic erythrocyte cut-off with LCLM was 7.5% (sensitivity 70%, specificity 68%) and PCM was 6.5% (sensitivity 74%, specificity 65%). Dysmorphic? flagging from UF-500i showed a sensitivity, specificity, PPV, NPV of 78%, 52%, 58% and 73%, respectively. LCLM can be considered a substitute for PCM for evaluating dysmorphic erythrocytes with its cut-off, so the clinician will be more alert to abnormalities that cause hematuria. Further research with larger samples and definite diagnosis with a kidney biopsy is needed to obtain more accurate results.
Validity of Chemiluminescent Immunoassay Serology Test for Anti-Sars Cov-2 Antibodies IgM and IgG 1 Museyaroh Museyaroh; Puspa Wardhani; Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1725

Abstract

In December 2019, an outbreak of acute pneumonia occurred in Wuhan, China. The disease was transmitted between humans through droplets (coughing or sneezing) of infected patients, causing this outbreak to spread rapidly in various countries in the world, including Indonesia. On February 11, 2020, WHO announced the pneumonia was caused by Coronavirus Disease 2019 (COVID-19), which was caused by a new type of Coronavirus, the SARS-CoV-2. A rapid and accurate diagnosis is critical for the control of the COVID-19 outbreak. The widely used test is a serology-based test that detects the  presence of SARS-CoV-2 IgM/IgG antibodies in the patient's body. One of the methods used for this test is Chemiluminescent Immunoassay (CLIA). This study aimed to determine the reliability of CLIA. The study was conducted from August to September 2020. The number of samples was 63 patients' serum. Polymerase chain reaction examination at Husada Utama Hospital, Surabaya, revealed that 21 patients were confirmed positive for COVID-19 with positive PCR results, and 42 patients were healthy with negative COVID-19 results. The results showed that IgM had a diagnostic sensitivity of 85.7%, diagnostic specificity of 92.8%, a positive predictive value of 85.7%, a negative predictive value of 92.8%,and accuracy of 90.4%. In comparison, IgG had a diagnostic sensitivity of 90.4%, diagnostic specificity of 90.4%, a positive predictive value of 82.6%, a negative predictive value of 90.5%, and accuracy of 90.4%. In conclusion, IgG has a higher sensitivity than IgM, while IgM had higher specificity, positive predictive value, and negative predictive value than IgG. However, the positive, negative predictive value and efficiency values were the same for IgM and IgG.
Determination of Cut-Off Index of Reactive HBsAg Based on Confirmatory Test at Dr. Moewardi Hospital Ellya Latifah Ilyas; JB. Suparyatmo; Amiroh Kurniati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1726

Abstract

HBsAg confirmatory test is required to confirm false reactive HBsAg due to non-specific binding of antigen with antibody. HBsAg confirmatory test cannot be performed in every laboratory due to the high price of reagents, short reagent shelf life, prolonged turnaround time, and increasing complexity of the test. This study aimed to determine the HBsAg COI (cut-off unit) cut-off point, which requires a confirmatory HBsAg test on the COBAS e411 analyzer with the ECLIA method. An observational analytic study with a cross-sectional approach was performed on 59 patients who underwent the HBsAg test at Dr. Moewardi Hospital, Surakarta in September-October 2020 on the Cobas e411 analyzer with the ECLIA method. The best analytical performance of cut-off index of reactive HBsAg was determined using the ROC curve and AUC. The results of initial HBsAg COI showed the following results: borderline with a mean: 0.975±0.0014 and reactive with a median of 4.38 (1.03-10)). The confirmatory test showed 59.8% reactive, 22.2% non-reactive, 13.8% not valid and 4.2% indeterminate results. The cut-off value for reactive HBsAg was 4.34 with an AUC of 0.818 (95% CI: 0.713 - 0.923; p=0.054), a sensitivity of 72.1% and a specificity of 87.5%. The initial cut-off of HBsAg index at 4.34 COI showed the best analytical performance with a sensitivity of 72.1% and specificity of 87.3%. Therefore, it can be used to determine HBsAg results that require HBsAg confirmatory examination on the Cobas e411 analyzer with the ECLIA method.
Selection of Hormonal Reference Values for Undescended Testicle Case in 8-Year-Old Boy with Abnormal Chromosome Vina Corry; Merci M. Pasaribu
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1727

Abstract

Establishing the diagnosis of undescended testicles requires appropriate hormonal laboratory reference values based on age and gender. An 8-year-old boy with an undescended testicle, mental retardation, and stunting had a blood test that was carried out at the Clinical Pathology Laboratory, dr. Cipto Mangunkusumo (RSCM) Hospital on February 6, 2020, with testosterone levels of 0.69 nmol/L (N male: 4.94-32.01 nmol/L) indicating decreased testosterone levels. The patient was consulted from urological surgery to pediatric endocrinology to determine the presence or rudiment of the patient'stesticles. Using the reference range of testosterone values assists clinicians in determining the diagnosis, monitoring therapy, and prognosis of a disease. There are some testosterone reference values, which are currently available, including Canadian Laboratory Initiative on Pediatric Reference Intervals Database (CALIPER) and the Tanner stage reference value. Later is more applicable because it is based on chronological age and secondary sexual development in assessing puberty development. A case of an 8-year-old boy with a clinical diagnosis of an undescended testicle, the laboratory test resultsshowed normal-low testosterone levels using the CALIPER and Tanner stage ranges according to the patient's age. No increase of testosterone levels after the second HCG stimulation test might be due to differences in the HCG administration protocol; therefore, the diagnosis of anorchia had not been established, and chromosome abnormalities of 46 XY, +6 Mar, 17 dmin on chromosome analysis suggested the suspected syndrome. These findings were consistent with the suspicion of primary hypogonadism in children with suspected syndrome caused by bilateral cryptorchidism with a suspected seminiferous tubular defect.
Prognostic Value of Platelet-Lymphocyte Ratio and High-Density Lipoprotein in Patients with Acute Myocardial Infarct Lestari Lestari; Sulina Yanti Wibawa; Amaliyah Tahir Lopa; Darmawaty Rauf
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1730

Abstract

Acute Myocardial Infarct (AMI) is the main reason for mortality. Platelet to Lymphocyte Ratio (PLR) describes thrombocyte aggregation and inflammation that is linked to cardiovascular disease. High-Density Lipoprotein (HDL) is antiatherogenic. This study aims to analyze the prognostic value of PLR and HDL in patients with AMI. This study was a retrospective observational study by obtaining laboratory results from complete blood count and lipid profiles from inpatients with AMI (STEMI and NSTEMI) medical records during Mei 2019–August 2020. Receiver Operating Characteristics (ROC) analysis was done to get the PLR and HDL cut-off. Prognostic value evaluation was based on sensitivity, specificity, positive and negative predictive value, and accuracy. Results obtained were from 302 subjects with a mean age of 58.4+9.6 years old, with most male patients (74.5%). Receiver operating characteristics curve analysis showed an 0.514 Area Under Curve (AUC) for PLR with p=0.685. High-density lipoprotein ROC was 0.573 with a p=0.033 (p< 0.05), with HDL cut-off = 50.0; sensitivity 72.7%, specificity 32.3%, positive predictive value 63.3%, negative predictive value 42.0% and 57.3% accuracy.Platelet to lymphocyte ratio mean was lower in the HDL <50 group (187.9) compared to the HDL > 50 (210.8), (p=0.009). High-density lipoprotein can be concluded as a potential prognostic factor of acute myocardial infarct. The lower the HDL, the greater the risk for a poor prognosis. A big-scale prospective study should be held to clarify and confirm these findings.
Relationship between Protein C and Antithrombin Levels with SOFA Score in Sepsis Nurma Sheila; Adi Koesoema Aman; Achsanuddin Hanafie
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1731

Abstract

Sepsis is a life-threatening organ dysfunction caused by the failure of the host's response against infection. Organ dysfunction in sepsis can be represented by an acute change in the SOFA score > 2 points as a consequence of infection. Proinflammatory cytokines in sepsis activate the coagulation cascade and cause a decrease in protein C and antithrombin III. This study aimed to determine protein C and antithrombin III levels in sepsis patients and their relationship with SOFA score. This study was an analytical study with a prospective cohort design. The subjects of this study were sepsis patients at Adam Malik General Hospital, Medan. Protein C, antithrombin III, and SOFA score were tested twice (first day and third day), and the relationship between protein C and antithrombin III with SOFA score was analyzed. From 33 samples, it was found that protein C and antithrombin III levels were lower in sepsis patients. There was a significant negative correlation between protein C and SOFA score on the first day (r= -0.502, p= 0.003), but no significant correlation was found on the third day. There was a significant negative correlation between antithrombin III and SOFA score on the first day (r= -0.513, p=0.002), but no significant correlation was found on the third day. It was concluded that there was a significant relationship between protein C and antithrombin III with SOFA score on the first day of sepsis patients.
Role of Lactic Acid as Predictor of Mortality in Patients with Acute Myocardial Infarction Novi Khila Firani; Theresa Sugiarti Oetji
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1734

Abstract

The hypoxic-ischemic condition causes tissue metabolic abnormalities and organ dysfunction, characterized by elevated blood lactic acid levels. It is suspected that increased lactic acid in Acute Myocardial Infarction (AMI) patients could increase mortality risk. This study aimed to determine whether increased lactic acid levels could be used as a predictor of mortality in AMI patients. The analytical observational-cohort study was performed on AMI patients who were admitted to Dr. Saiful Anwar Malang Hospital from January 2018 to December 2019. Research subjects were divided into two groups, the group of deceased and living AMI patients, who were tested for lactic acid, troponin-I, CKMB, and creatinine levels at admission. Diabetes mellitus and septic patients were excluded. For analysis of lactic acid as a predictor of mortality, ROC curve analysis and odds ratio were used. There found that lactic acid levels in the deceased AMI patients group were higher compared to that of the living AMI patients (p < 0.05). The sensitivity and specificity values of lactic acid as a predictor of mortality in AMI patients at a cut-off of 3.5 mmol/L were 66.7% and 80%, respectively. Odds ratio analysis showed that AMI patients with lactic acid levels more than 3.5 mmol/L had 8 times greater mortality risk than those whose level less than 3.5 mmol/L. It was concluded that lactic acid level can be used as an indicator to predict the mortality of AMI patients.
Comparison of K2 and K3 EDTA Anticoagulant on Complete Blood Count and Erythrocyte Sedimentation Rate Harida Zahraini; Yulia Nadar Indrasari; Hartono Kahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1735

Abstract

The use of anticoagulants is one of the important pre-analytic factors in hematological tests. Both dipotassium (K2) andtripotassium (K3) Ethylene Diamine Tetraacetic Acid (EDTA) are widely used anticoagulants. International CouncilStandardization of Hematology (ICSH) and several researchers recommend the use of K2 EDTA due to its less hyperosmolareffect on blood cells compared to K3 EDTA. This study aimed to compare the results of Complete Blood Count (CBC) andErythrocyte Sedimentation Rate (ESR) using anticoagulant K2 EDTA and K3 EDTA. This study was an analytic observationalstudy with a cross-sectional design conducted from April to December 2018. The subject of the study were 103 healthyadults selected by consecutive sampling. Blood samples were collected in both anticoagulant tubes with a volume of 3 mLeach. Samples were tested twice, in the first 0 hours and the next 6 hours using Sysmex XN 1000 and Alifax Roller 20 LC.Kolmogorov-Smirnov test, paired T-test and Wilcoxon rank test were used for statistical analysis. The agreement testbetween both anticoagulants was carried out using the Bland Altman plot for parameters with a significant difference. Therewas a significant difference between both anticoagulants for the parameters of hemoglobin, hematocrit MCV, MCHC, RDW,PDW, MPV, PLC-R, and erythrocyte sedimentation rate in both the first and second tests. The agreement test using the BlandAltman plot showed that the difference in these parameters was within the Limit of Agreement (LOA) range of 95%. Thisstudy showed that there were differences in some parameters of complete blood count and erythrocyte sedimentation ratebetween the two anticoagulants (K2 K3 EDTA), but these differences were within the LOA range.

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